High Co-Payments Save Employers Money

High Co-Payments Save Employers Money

Jun 20, 2007 6:00 PM

Changes in benefits led some employees to switch, stop taking
medications

SALT LAKE CITY - Shifting the cost of
prescription drugs, in the form of higher co-payments for
health-plan members, saved employers up to $305 a year per worker
without affecting short-term total health-care costs for any of
five diseases, new research from the University of Utah
Pharmacotherapy Outcomes Research Center and Intermountain
Healthcare shows.

The study, published in the June issue of The American
Journal of Managed Care , found, depending on which disease
they had, some workers continued with their same medication, while
others changed to less expensive ones, and others stopped taking
them altogether when their co-payments increased.

Researchers at the University's Pharmacy Outcomes Research
Center, part of the College of Pharmacy, tracked the effect of
higher prescription co-payments on the costs of employer-sponsored
health plans and total health-care costs from January 2001 through
December 2002. The study followed employees taking medication for
osteoarthritis, asthma, allergic rhinitis, high blood pressure, and
diabetes.

The researchers studied companies and workers whose health
insurance is provided through SelectHealth, a subsidiary of
Intermountain Healthcare in Salt Lake City. Changes in the benefit
designs were made at the employers' request.

Lead author Diana I. Brixner, Ph.D., R.Ph., chair of the
Department of Pharmacotherapy at the University's College of
Pharmacy, called the study's findings mixed. "Co-payment increases
can appropriately decrease costs for a health-care system without
showing negative effects on costs in other areas," she said. "But
discontinuing their medication may affect individual patients."

Brixner cautioned the study looked at medical outcomes for only
a year following the co-payment increases, so longer-term effects
on the overall costs weren't studied. The effect of the higher
co-payments was compared with workers in a control group whose
prescription costs did not increase.

Those with diabetes, a disease that needs constant monitoring
and can be subject to sudden changes, were least likely to switch
or discontinue medications. Nearly 54 percent of these diabetes
patients continued with their current prescriptions, while 22
percent switched to cheaper ones, and 20 percent stopped taking
medication altogether. The percentage of employees who stopped
their medication did not differ from that of the control group.

Patients with osteoarthritis, allergic rhinitis, and asthma were
more likely to discontinue their prescriptions, with more than 60
percent stopping their drug therapy when the co-payment went up.
But 50 percent of patients in the control group stopped their
medication as well, indicating the discontinuation rate among
patients for these three diseases is higher regardless of the
co-payment. Only 5 percent to 10 percent of patients whose
co-payments increased switched to cheaper drugs, while 25 percent
to 30 percent stayed on the same medication. Patients' decisions
may have been affected by the acute or seasonal nature of these
diseases and the availability of over-the-counter medications for
osteoarthritis pain and allergic rhinitis, Brixner said.

The group with high blood pressure was more evenly distributed
between continuing with the same prescriptions (43 percent) and
stopping medication altogether (39 percent).

The yearlong prescription cost savings for employers ranged from
$92 for each employee with diabetes, $95 for those with allergic
rhinitis, $180 for high blood pressure, $269 for asthma, and $305
for workers taking drugs for osteoarthritis.